Des Moines Register investigations in 2018 exposed strong-arm attacks against state 4-H organizations over a proposed LGBTQ inclusion policy, documented ongoing problems with Iowa’s privately managed Medicaid program and prompted a governor’s candidate to quit the race after publication of sexual misconduct allegations raised by three women.

I consider investigative reporting to be a top newsroom priority. Our journalists file public-records requests to pry out information that some officials would rather stay secret. Our reporting holds those in power accountable and helps improve the lives of everyday Iowans.

For the third year, I’ve compiled a top 15 recap of some the most impactful investigative journalism produced by the Register and USA TODAY Network. Being part of the Network means investigative reporters from across the company can focus their efforts on an Iowa story, and the Register also can publish important investigations developed by Network reporters elsewhere around the country.

Federal pressure on 4-H over LGBTQ policy

In August, Iowa columnist Courtney Crowder reported on the firing of John-Paul Chaisson-Cárdenas, leader of Iowa 4-H Youth Development, which occurred months after a furor erupted over a suggested 4-H LGBTQ inclusion policy that he had championed.

Crowder and investigative reporter Jason Clayworth conducted extensive interviews and examined more than 500 pages of state and federal communications to document that members of the Trump administration had pushed the national 4-H organization to withdraw the policy.

That pressure helped lead to the ouster of Chaisson-Cárdenas, their reporting showed.

Their reporting also prompted U.S. Sen. Chuck Grassley to say that the federal government should not have pressured 4-H about the matter. He said the group "should be relatively free of government control."

About 600,000 poor or disabled Iowans have their health care covered by Medicaid, which has been managed by for-profit companies since 2016.
Wochit

Oversight of Medicaid services

Everyone — multiple medical officials, an administrative law judge, the Iowa Department of Human Services director — agreed that 70-year-old Ann Carrigan of Spencer needed a specialized wheelchair so her atrophied muscles wouldn't cause her to choke or fall out. Everyone, that is, except the doctors at UnitedHealthcare, one of the private companies managing Iowa’s Medicaid program.

It took 15 months for appeals to play out before a district court judge ruled that Carrigan should get the wheelchair. In the meantime, a Nebraska company gave her the equipment without knowing whether it would be reimbursed by UnitedHealthcare.

“You don't let a disabled person sit in a bed or choke," company vice president Ken Sander said.

Carrigan was one of the Iowans featured in a Jason Clayworth's investigation that exposed a Medicaid appeals process stacked against patients and families.

Clayworth’s investigation was part of ongoing reporting by the Register on problems with the way Iowa’s privatized Medicaid program serves Iowans.

For the second straight year, UnitedHealthcare attempted to reduce the hours provided, which allow Campbell to live independently in his own home. Campbell is one of several disabled Iowans the Register has highlighted who have struggled to maintain care after the state’s shift to private Medicaid management.

Problems with the state’s Medicaid program became a major issue in the governor’s race, and Gov. Kim Reynolds has pledged to ensure that participants receive the services they deserve and providers are paid on time.

Kirsten Anderson, a former communications director for the Iowa Senate Republican caucus, reacts to the verdict in her sexual harassment lawsuit against the State of Iowa after she was awarded $2.2 million by a Polk County jury.

Sexual misconduct at the Capitol

For more than a decade, Iowa legislators and staff members engaged in lewd and sexually aggressive behavior that created a "toxic" environment, and lawmakers were either unable or unwilling to promptly address the problem, a Register investigation by Jason Clayworth found.

The behavior was detailed in depositions, taken under oath by about two dozen lawmakers and legislative staffers, comprising more than 1,000 pages of documents previously unreleased to the public.

Clayworth’s three-part investigation also reported that legislators had made piecemeal policy fixes intended to combat sexual harassment, but some aspects fell short of standards set by the National Conference of State Legislatures.

He also reported that claims of misconduct against state Sen. Boulton, which allegedly occurred before his election to the Legislature, would be a key test of whether lawmakers could be held accountable for conduct outside the Capitol.

In December, the bipartisan Senate Ethics Committee voted unanimously to dismiss an ethics complaint against Boulton, concluding that its jurisdiction didn’t extend to alleged incidents before he was elected.

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This dementia, which affects mainly people in their 40s to 60s, differs from Alzheimer's. As many as 50,000 Americans may have FTD.
Wochit

Iowa’s mental health care crisis

Gailen Clausen, 55, and Tommy Nash, 47, have severe forms of dementia, which not only rots away their brains but also has prompted them to push or slap at relatives and nursing home staff members.

Iowa nursing homes are increasingly turning away dementia victims, reporter Tony Leys found. That’s why Clausen now lives in a Story City nursing home, 190 miles from his family’s home in the northwest Iowa town of Craig, and Nash lives in a Newton nursing home, 125 miles south of his hometown of Osage.

Leys’ series helped make the inadequacies of Iowa’s mental health system a major issue in November's governor’s and legislative races. I also hope it will help pressure legislators and Gov. Kim Reynolds to follow through with funding new mental health services approved by the 2018 Legislature and with establishing a mental health system for children.

Public money to private schools

Polk County routed $844,000 in public money to nine Catholic schools and one Christian academy in 2012 and 2013, despite state law and county policies prohibiting public funding for religious institutions.

The money was paid in the form of grants to a corporation set up to pass the money to the schools, Clark Kauffman found. The money came from the county’s share of gambling revenue from Prairie Meadows Casino and Hotel.

In a statement, the Polk County Board of Supervisors said it was "proud of the contributions" and believed it had complied with the spirit of state law. The Diocese of Des Moines conducted a review and concluded the county was legally allowed to send the public money to private schools.

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Despite having constant dreams about meth, 25-years-old Genna Reed said she wants to be a success story.
Rodney White, rodwhite@dmreg.com

Increases in meth addiction, violent crime

Lee Rood, the Register’s Reader’s Watchdog, does a year-end look back at her investigations, the vast majority of which are suggested by readers. I encourage you to read her wrap-up, but I’ll mention a pair of special reports on troubling trends that deserve increased attention from state leaders.

As her year-end column suggests, "If you live in some of the rural counties hardest hit by this drug-related crime, you may want to ask local law enforcement and your state legislators what their plan is for dealing with that growing problem."

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A USA TODAY/Kaiser Health News investigation of public records found that surgery centers have risked lives by operating on frail patients, by skimping on life-saving training and equipment and by sending patients home too soon.
USA TODAY

Deadly outcomes at surgery centers

Twelve-year-old Reuben Van Veldhuizen of Oskaloosa was scheduled for a tonsillectomy and adenoidectomy at West Lakes Surgery Center in Clive on a summer day in 2016. But his heart seized during the procedure, a reaction to an anesthetic that carries a warning about the risk of cardiac arrest in young boys, according to the family’s lawsuit.

Thirty-seven minutes after the surgery, center staff called 911, the boy made it to a hospital, where he was pronounced dead.

In court filings, the surgery center and anesthesiologist said the death resulted from pre-existing conditions or acts of others and denied responsibility. On Oct. 17, the parties in the lawsuit went to mediation and reached an undisclosed settlement.

The boy's death was highlighted in a March Kaiser Health News/USA TODAY Network investigation that found surgery centers have steadily expanded their business, and staffers call 911 thousands of times a year as patients experience complications.

Yet no one knows how many people die as a result, because no national authority tracks the outcomes.

Stephen pleaded guilty in October to child pornography and sexual exploitation offenses, acknowledging he possessed nude images or videos of approximately 400 boys, some of whom he photographed or recorded himself.

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Judge Edward A. Jacobson has admitted that hundreds of his decisions were authored by the prevailing attorney in those cases. The admission has triggered at least two ethics investigations and an order to preserve Jacobson's emails.
Clark Kauffman / The Register

The admission prompted Supreme Court Chief Justice Mark Cady to order all Iowa judges to attend a one-hour educational course on the importance of avoiding private communications with only one side in a case.

Such communications “undermine fairness and create the appearance of bias and partiality,” Cady said in his order.

In at least one case, an Iowa court nullified a Jacobson decision that involved a divorce decree. The couple’s marriage remained legally dissolved, but a new trial was to be scheduled to settle issues related to child custody, visitation and the division of property.

New light on police shooting

A federal judge in August ordered the release of video and other records in the 2015 police shooting death of Burlington mother Autumn Steele, a step long sought by her family and open-records advocates.

Burlington Police Officer Jesse Hill has said the Steele family's dog attacked him and he pulled his weapon, slipped and accidentally shot Steele. Hill has never been disciplined in connection with the shooting.

Reporter Jason Clayworth undertook a detailed examination of the video and hundreds of pages of documents that were made public.

Hill can be heard on police body-cam video telling another officer at the scene, “I’m … going to prison,” a statement previously excluded from public documents. In addition, Clayworth found, witnesses' statements in previously disclosed records did not reflect their on-scene comments that they did not believe the dog was being aggressive in the moments before Hill fired his gun.

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Jonathan Landeros-Cisneros, a student at Iowa State, is in his sophomore working on a degree in Anthropology. Last year he took a semester off to help his family by working a manual labor job. He said the work motivated him to go back to school.
Bryon Houlgrave/The Register

Struggles of Pell grant recipients

Federal Pell grants have long been viewed as a key vehicle that helps students from low-income families afford college and push open doors of opportunity.

But far fewer Pell grant recipients go on to graduate than students who don’t receive the grants, an examination of data made public by new federal reporting requirements found. Higher-education reporter Kathy Bolten reviewed data from more than 1,900 four-year public and private institutions.

In Iowa, 57 percent of Pell grant recipients graduated from the state's four-year institutions within six years, compared with 75 percent of non-Pell students. That gap of 18 percentage points is slightly better than the 21-point national gap, Bolten found.

"If we are investing money in students and they are not completing, that should be a big concern for everyone," said Bill DeBaun, director of data and evaluation at the National College Access Network, a Washington, D.C.-based advocacy group.

Mass cancellation of diagnostic orders at VA hospitals

When a patient arrived at the Department of Veterans Affairs hospital in Iowa City in February 2017 for a CT scan, but the doctor’s order for it had been canceled, radiology technologist Jeff Dettbarn said he knew something was wrong.

He started collecting cancellation notices for diagnostic procedures such as CT scans, MRIs and ultrasounds, none of which were canceled by a physician, he said.

It turns out that more than 250,000 radiology orders at VA hospitals across the country have been canceled since 2016, part of a rush to clear out outdated and duplicated diagnostic orders. But questions linger about whether some medically necessary orders for CT scans and other imaging tests were canceled improperly, a report by Donovan Slack of USA TODAY and Tony Leys of the Register found.

The VA inspector general is auditing the mass cancellations at nine VA medical centers, including Iowa City.

Dettbarn alerted the hospital’s compliance officer about his concerns, but he has faced disciplinary proceedings, which he has said were an effort to retaliate against him.

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Lori Minor says she was sexually abused as a teen by Wing-Tai Fung, who practiced medicine in Harlan for 37 years and is now on the Iowa sex offender registry after pleading guilty in 2015 to sexual abuse charges involving a 10-year-old patient.
Zach Boyden-Holmes/The Register

Clayworth also teamed with the Corpus Christi, Texas, Caller Times to break a story in the past week that the Tipton brothers have repaid less than $1,400 in restitution, despite owning property worth nearly $2 million.

Carol Hunter is the Register’s executive editor. She wants to hear from you with questions, story ideas or concerns. Contact her at 515-284-8545, chunter@registermedia.com or on Twitter, @carolhunter.

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